AVON MEDICAL WELLNESS CENTER LLC NPI 1134509615

NPI Information

NPI: 1134509615
Provider Name: AVON MEDICAL WELLNESS CENTER LLC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
540 HOPMEADOW ST
SIMSBURY, CT
ZIP 06070
Phone: (860) 272-4646
Get Directions

AVON MEDICAL WELLNESS CENTER LLC is a cardiovascular disease internal medicine in Simsbury, CT. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. AVON MEDICAL WELLNESS CENTER LLC NPI is 1134509615. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

540 HOPMEADOW ST
SIMSBURY, CT
ZIP 06070-496
Phone: (860) 272-4646
Fax: (860) 272-4642

The provider's authorized official is Ofer Sagiv .
The authorized official title is President/owner and has the following contact phone number (860) 272-4646.

The enumeration date for this NPI number is 6/1/2015 and was last updated on 12/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	047333	CONNECTICUT	Yes
2	363AM0700X	Physician Assistant	Medical	001816	CONNECTICUT	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	047333	OTHER	CONNECTICUT	STATE LICENSE
2	PENDING	MEDICARE PIN	CONNECTICUT
3	PENDING	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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